Here's how Robert F. Kennedy Jr. has promised to remake the nation's top health agencies

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Here's how Robert F. Kennedy Jr. has promised to remake the nation's top health agencies

2024-11-16 07:27 Last Updated At：07:31

WASHINGTON (AP) — Robert F. Kennedy Jr., an anti-vaccine activist and environmentalist, for years gained a loyal and fierce following with his biting condemnations of how the nation’s public health agencies do business.

And that's put him on a direct collision course with some of the 80,000 scientists, researchers, doctors and other officials who work for the Department of Health and Human Services, especially with President-elect Donald Trump tapping him to head the agency.

If confirmed, Kennedy will control the world's largest public health agency, and its $1.7 trillion budget.

The agency's reach is massive. It provides health insurance for nearly half of the country — poor, disabled and older Americans. It oversees research of vaccines, diseases and cures. It regulates the medications found in medicine cabinets and inspects the foods that end up in cupboards.

A look at Kennedy's comments about some of the agencies that fall within the HHS arena, and how he has said he plans to shake them up:

— “FDA’s war on public health is about to end,” he wrote on X in late October. “If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Preserve your records, and 2. Pack your bags.”

The FDA’s 18,000 staffers include career scientists, researchers, and inspectors responsible for the safety and effectiveness of prescription drugs, vaccines and other medical products. The agency also has broad oversight of a swath of consumer goods, including cosmetics, electronic cigarettes and most foods.

HHS has legal authority to reorganize the agency without congressional approval to maintain the safety of food, drugs, medical devices and other products.

And Kennedy has long railed against the FDA’s work on vaccines. During the COVID-19 epidemic, his nonprofit group, Children’s Health Defense, petitioned the FDA to halt the use of all COVID vaccines. The group has alleged that FDA is beholden to “big pharma” because it receives much of its budget from industry fees and some employees who have departed the agency have gone on to work for drugmakers.

His attacks have grown more sweeping, with Kennedy suggesting he will clear out “entire departments” at FDA, including the agency’s food and nutrition center. The program is responsible for preventing foodborne illness, promoting health and wellness, reducing diet-related chronic disease and ensuring chemicals in food are safe.

Last month, Kennedy threatened on social media to fire FDA employees for “aggressive suppression” of a host of unsubstantiated products and therapies, including stem cells, raw milk, psychedelics and discredited COVID-era treatments like ivermectin and hydroxychloroquine.

In the case of hydroxychloroquine, for example, the agency halted its emergency use after determining it wasn't effective in treating COVID and raised the risk of potentially fatal heart events.

Consuming raw milk has long been regarded as risky by the FDA because it contains a host of bacteria that can make people sick and has been linked to hundreds of illness outbreaks.

If confirmed, Kennedy in principle could overturn almost any FDA decision. There have been rare cases of such decisions in previous administrations. Under both George W. Bush and Barack Obama, HHS overruled FDA approval decisions on the availability of emergency contraceptives.

Unwinding FDA regulations or revoking approval of longstanding vaccines and drugs would likely be more challenging. FDA has lengthy requirements for removing medicines from the market, which are based on federal laws passed by Congress. If the process is not followed, drugmakers could bring lawsuits that would need to work their way through the courts.

— “On January 20, the Trump White House will advise all U.S. water systems to remove fluoride from public water,” Kennedy wrote on social media in November.

The CDC's fluoride guidance is just one recommendation the agency has made as part of its mission to protect Americans from disease outbreaks and public health threats.

The agency has a $9.2 billion core budget and more than 13,000 employees

Days before Trump’s victory, Kennedy said he would reverse the agency’s recommendations around fluoride in drinking water, which the CDC currently recommends be at 0.7 milligrams per liter of water.

The recommendations have strengthened teeth and reduced cavities by replacing minerals lost during normal wear and tear. Splotchy teeth patterns have occurred with higher levels of fluoride, prompting the U.S. government to lower its recommendations from 1.2 milligrams per liter of water in 2015.

Local and state governments control the water supply, with some states mandating fluoride levels through state law.

Kennedy, who has said “there's no vaccine that is safe and effective,” would be in charge of appointments to the committee of influential panel experts who help set vaccine recommendations to doctors and the general public. Those include polio and measles given to infants and toddlers to protect against debilitating diseases to inoculations given to older adults to protect against threats like shingles and bacterial pneumonia as well as shots against more exotic dangers for international travelers or laboratory workers.

— “We need to act fast," Kennedy was reported to have said during an a Scottsdale, Arizona event over the weekend. “So that on Jan. 21, 600 people are going to walk into offices at NIH and 600 people are going to leave.”

The agency's $48 billion budget funds medical research on cancers, vaccines and other diseases through competitive grants to researchers at institutions throughout the nation. The agency also conducts its own research with thousands of scientists working at NIH labs in Bethesda, Maryland.

Among advances that were supported by NIH money are a medication for opioid addiction, a vaccine to prevent cervical cancer, many new cancer drugs and the speedy development of mRNA COVID-19 vaccines.

In the past, Kennedy has criticized NIH for not doing enough to study the role of vaccines in autism.

Kennedy wants half of the NIH budget to go toward “preventive, alternative and holistic approaches to health,” he wrote in the Wall Street Journal in September. “In the current system, researchers don’t have enough incentive to study generic drugs and root-cause therapies that look at things like diet.”

Kennedy wants to prevent NIH from funding researchers with financial conflicts of interest, citing a 2019 ProPublica investigation that found more than 8,000 federally funded health researchers reported significant conflicts such as taking equity stakes in biotech companies or licensing patents to drugmakers.

— “If a doctor’s patient has diabetes or obesity, the doctor ought to be able to say, I’m going to recommend gym membership, and I’m going to recommend, good food and Medicaid ought to be able to finance those things the same as they would Ozempic,” Kennedy said during a Sept. 30 town hall in Philadelphia.

Kennedy has not focused as much on the agency that spends more than $1.5 trillion yearly to provide health care coverage for more than half of the country through Medicaid, Medicare or the Affordable Care Act.

Even as Trump and other Republicans have threatened some of that coverage, Kennedy has remained mum.

Instead, he's been an outspoken opponent of Medicare or Medicaid covering expensive weight-loss drugs, like Ozempic or Zepbound. Those drugs are not widely covered by either program, but there's some bipartisan support in Congress to change that.

Speaking during a congressional roundtable in September, Kennedy admonished some for supporting that effort, noting it could cost the U.S. government trillions of dollars. An exact price tag for the U.S. government to cover those drugs has not been determined.

Kennedy has said Medicare and Medicaid should, instead, provide gym memberships and pay for healthier foods for those enrollees.

“For half the price of Ozempic, we could purchase regeneratively raised, organic food for every American, three meals a day and a gym membership, for every obese American,” Kennedy said.

Associated Press writers Carla K. Johnson in Seattle and Mike Stobbe in New York contributed to this report.

APEC leaders hold Lima summit as Trump prepares to return to office

2024-11-16 07:28 Last Updated At：07:30

LIMA, Peru (AP) — Leaders of Pacific Rim countries including the U.S. and China gathered Friday in Peru for an Asia-Pacific Economic Cooperation meeting, the first major global summit since U.S. President-elect Donald Trump’s election victory.

The annual gathering brings together 21 economies that jointly account for almost two-thirds of global GDP and half the world’s trade, according to organizers.

Outgoing U.S. President Joe Biden joined China’s President Xi Jinping, Canada’s Prime Minister Justin Trudeau, Indonesia’s President Prabowo Subianto, Japan’s Prime Minister Shigeru Ishiba, Australia’s Prime Minister Anthony Albanese and others as the world wonders how a new U.S. government might upend global dynamics.

Leaders and other representatives will hold closed-door discussions in the morning, following a welcome address by Peru's President Dina Boluarte that focused on the need to promote inclusive growth and reduce informal labor in APEC economies.

“Our objective is to level the playing field, providing all the necessary tools for inclusion in social, financial and commercial spaces,” Boluarte said. “We are convinced that growth starts with inclusion and that this is only possible through the empowerment of the citizenry that is the motor of our economies.”

APEC is bound to be one of Biden's last global summits before leaving office, and White House officials insist that his attendance as well as his subsequent visit to Brazil for the Group of 20 meeting next week will be substantive, with talks to focus on climate issues, global infrastructure, counter-narcotic efforts. The officials say Biden also will use the summits to press allies to keep up support for Ukraine as it tries to fend off Russia’s invasion and persist in negotiating an end to Israel's wars in Lebanon and Gaza.

For the first time since last year’s APEC forum, Biden will meet one-on-one with Chinese President Xi on Saturday. He met Peru’s Boluarte early afternoon Friday, and later with South Korea’s Yoon Suk Yeol and Japan’s Shigeru Ishiba.

Biden praised the cooperation between South Korea, Japan and the U.S. at countering what he described as North Korea’s “dangerous and destabilizing cooperation with Russia.” He celebrated the partnership between Japan and South Korea, two countries that have historical enmity but under Biden’s presidency are now tightening security and economic ties as their corner of the world becomes more complicated.

“This is likely to be my last trilateral meeting with this important group. But I’m proud to have helped be one of the parts of building this partnership, and I think it’s built to last. That’s my hope and expectation. I truly believe cooperation of our countries will be the foundation to peace and stability in the Indo-Pacific for many years to come," Biden said.

Through a translator, Ishiba echoed the sentiment: “I look forward to furthering our partnership in response against North Korea and in many other areas.”

Still, analysts said Biden may be overshadowed at APEC by Xi, who on Thursday night started his visit by inaugurating a $1.3 billion megaport that is perhaps the clearest sign of Latin America’s ongoing reorientation in the region.

Xi also met with Yoon on Friday. The Chinese leader appealed to neighborliness and cultural affinity, urging closer ties including contacts both at the high level and among people, according to China's state broadcaster CGTN. Xi told Yoon that the two countries should work together to safeguard the international free trade system and ensure the stability of the global supply chains, as Beijing is bracing for the Trump administration. Trump has threatened to impose 60% tariffs on Chinese goods.

Beijing announced on Nov. 1 that South Korean citizens can travel to China visa-free for up to 15 days, a move seen as countering the U.S.-Japan-South Korea alliance.

Xi also held bilaterals Friday with Singapore’s Prime Minister Lawrence Wong, Thailand’s Prime Minister Paetongtarn Shinawatra, Chile’s President Gabriel Boric and New Zealand’s Prime Minister Christopher Luxon, according to CGTN. On Thursday, he sat down privately with Boluarte.

Addressing questions regarding an incoming Trump administration at the APEC CEO summit, Canada's Trudeau recalled the last time Trump took office, pledging to rip up the North American Free Trade Agreement. Instead, he said, the nations worked hard to find ways to forge new terms, known as the U.S.-Mexico-Canada Agreement, that served as proof trade can be beneficial to all parties.

“It wasn’t easy. And nothing is going to be easy this time,” Trudeau said. “Little secret: There is no American administration that is automatically easy for a Canadian government. They take a very robust look at their own interests and Canada adjusts.”

Likewise U.S. Secretary of State Antony Blinken used his 10-minute speech to champion more robust engagement with the world. Facing an audience seemingly drained by the long day of speeches, he joked: “I understand I’m the only thing standing between most of you and a Pisco sour” — Peru's national cocktail.

Although he didn’t mention Trump by name – nor his protectionist “America First” doctrine – Blinken offered a spirited defense of the Biden administration’s focus on reviving global relationships.

“Around the world we reimagined, re-energized, revitalized, strengthened and wove together our alliances and partnerships to try to advance an increasingly shared vision for a future,” he said.

He said Washington in recent years had stepped up involvement in multilateral organizations like APEC, saying such forums “are incredibly important. They concentrate minds.”

Outside Lima’s Convention Center where APEC is sited, metal barriers and police equipped with riot gear are surrounding the perimeter. For the past two days, anti-government protesters angry about a recent spate of gang-fueled violence have shouted slogans demanding that their wildly unpopular president take action against the crime wave.

The rallies have devolved into scuffles with police, who used batons to drive away the more aggressive protesters on Thursday. As APEC leaders gathered on Friday, a few dozen protesters were stopped by security barricades several blocks from the convention center. Vastly outnumbered by riot police, they chanted against government corruption and denounced Boluarte for the deaths of dozens of protesters in the wake of her predecessor’s ouster.

“Why would we want APEC here when the investment is just going to line their pockets?” Maria Melendez, a 48-year-old tour guide said of corrupt government officials. “We’re hungry and they’re over there talking about billions of dollars. How is that going to help us?”

Mia Rivera, 58, held a portrait of the ousted president, Pedro Castillo, and said she was discouraged by the low turnout. She said the heavy police presence and memory of the violent crackdown against demonstrators in 2022 deterred many of her friends from marching this week.

Associated Press writers Aamer Medhani in Lima and Didi Tang in Washington contributed.